What Kind of Support Can Help You Lose Weight?
By Shawn Stevenson, DO, FACS – Chief of Bariatric and Foregut Surgery, Dignity Health
When I talk with patients about weight loss, one of the first things I try to reframe is the idea that it’s something you’re supposed to do on your own. Many people come in feeling like they’ve failed because they haven’t been able to make weight loss stick by themselves.
In my experience, successful and sustainable weight loss almost always depends on having the right support in place. This isn’t about willpower or motivation. It’s about biology, preparation, and building a plan you can maintain over the long term.
Weight is regulated by complex systems in your body, including hormones, metabolism, insulin response, and how your brain processes hunger and fullness. For many people, those systems are working against them, even when they’re doing many of the “right” things.
Medical weight-loss support allows me to step back and look at the whole picture. That includes how your body functions, what medical conditions may be contributing to weight gain, and which approach makes sense based on your health and goals. The goal isn’t just to help you lose weight. It’s to improve how your body regulates weight so that results are more durable over time.
Nutrition works best when it’s realistic. I don’t believe in perfection, extreme restriction, or plans that only work in theory.
Patients tend to do better when they have clear structure, practical guidance, and expectations that fit real life. Dietitians and nutrition specialists help translate medical recommendations into daily habits. This includes not just what to eat, but how to eat in a way that supports long-term success rather than short-term swings.
Weight loss is personal. It affects how you feel about yourself, how you manage stress, and how you stay motivated over time.
For some patients, behavioral support, whether that’s coaching, counseling, or accountability, plays an important role. This isn’t about judgment or blame. It’s about recognizing that lasting change is much more achievable when people feel supported rather than pressured.
Medications such as GLP-1 therapies have received a lot of attention, and for good reason. For the right patient, these medications can be very helpful. They work by reducing hunger, helping you feel full sooner, and improving metabolic control, which can make lifestyle changes more achievable.
That said, GLP-1 medications are not a silver bullet. They don’t permanently change anatomy, and they don’t eliminate the need for nutritional guidance, behavioral support, or long-term planning. In many cases, weight regain can occur if medication is stopped without a broader strategy in place.
I don’t view medication as a shortcut or a failure. When used appropriately, it’s simply one tool. Sometimes it’s a bridge, and sometimes it’s part of a longer-term plan. Either way, it works best when combined with medical oversight and a strong support system. The key is using medication thoughtfully and in the right context.
For patients who meet medical criteria, bariatric surgery is not just weight-loss surgery. It’s metabolic surgery. It changes how the body processes food, hormones, and energy.
Surgery can improve or even resolve conditions like diabetes and high blood pressure, and it can support durable, long-term weight loss. The best outcomes happen when surgery is combined with ongoing medical follow-up, nutritional guidance, and a shared commitment between the patient and the care team.
One of the most important factors in long-term success is having a consistent, experienced care team. Weight loss isn’t a single visit or a single decision. It’s a process that unfolds over time.
I want patients to know that we are in this together for the long haul. There is no simple solution. Every treatment, every decision, and every step matters because it matters to you.
The right support helps you understand which tools make sense for you, medically, nutritionally, behaviorally, and surgically, both now and in the future.
The goal isn’t just weight loss.
The goal is better health, improved function, and the ability to live your life more fully.
And that happens best when you don’t have to do it alone.
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